A system at risk: Critical gaps in healthcare provider competency and hospital preparedness for CBRNe threats in a geopolitically exposed nation

IF 2.2 4区医学 Q2 NURSING

International Emergency Nursing Pub Date : 2026-03-01 Epub Date: 2026-02-23 DOI:10.1016/j.ienj.2026.101777

Eman S. Qzih , Muayyad M. Ahmad

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引用次数: 0

Abstract

Background: Global health security is increasingly threatened by Chemical, Biological, Radiological, Nuclear, and Explosive (CBRNe) incidents. Frontline nurses, as first responders, are critically exposed, yet evidence on their readiness in high-risk regions remains scarce.

Aim: This study aimed to conduct the first dual-level, system-wide evaluation of CBRNe preparedness in Jordan. It specifically sought to benchmark the practical competency of the nursing workforce and hospital-level readiness.

Methods: A mixed-methods cross-sectional study was performed across five major hospitals, involving 298 frontline providers (predominantly nurses, 69.5%, n = 207) and 30 senior administrators. The study utilized a validated provider skills assessment and the Canadian Centre for Emergency Preparedness (CEEP) survey. Data were analyzed using descriptive statistics and the Kruskal-Wallis H-test.

Results: A critical gap between policy and practice was identified, revealing a acute vulnerability among nurses. While all providers were competent in basic (Level D) personal protective equipment (PPE), proficiency plummeted to 14.8% for Level B and 1.7% for Level A. Furthermore, 76.8% of providers had never participated in a CBRNe simulation, and only 20.5% felt capable of performing casualty decontamination, a core nursing responsibility. Hospital-level preparedness varied drastically (p < 0.001), revealing a pronounced military-civilian divide. The top-performing hospital scored 67.7% in biological preparedness, while the lowest scored 16.7% in chemical preparedness.

Conclusions: This study uncovers a systemic failure in translating CBRNe policy into frontline practice, creating a dangerous vulnerability that disproportionately impacts nurses as first responders. The findings mandate an urgent paradigm shift from fragmented, facility-specific efforts to a standardized, nationally-integrated CBRNe readiness strategy that prioritizes and empowers the nursing workforce.

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面临风险的系统：在地缘政治暴露的国家，医疗保健提供者能力和医院对CBRNe威胁的准备存在重大差距。

背景：全球卫生安全日益受到化学、生物、放射、核和爆炸（CBRNe）事件的威胁。作为第一响应者的一线护士面临着严重的风险，但关于她们在高风险地区做好准备的证据仍然很少。目的：本研究旨在对约旦CBRNe准备工作进行首次双层面全系统评估。它特别寻求基准护理人员的实际能力和医院水平的准备。方法：在5家大医院进行了一项混合方法的横断面研究，涉及298名一线提供者（主要是护士，占69.5%,n = 207）和30名高级管理人员。该研究采用了经过验证的提供者技能评估和加拿大应急准备中心（CEEP）调查。数据分析采用描述性统计和Kruskal-Wallis h检验。结果：政策和实践之间的关键差距被确定，揭示了护士的急性脆弱性。虽然所有医护人员都具备基本（D级）个人防护装备（PPE）的能力，但B级和a级医护人员的熟练程度分别下降到14.8%和1.7%。此外，76.8%的医护人员从未参加过CBRNe模拟，只有20.5%的医护人员有能力执行伤员净化（核心护理责任）。结论：本研究揭示了将CBRNe政策转化为一线实践的系统性失败，造成了一个危险的脆弱性，对作为第一响应者的护士造成了不成比例的影响。研究结果要求紧急转变模式，从分散的、针对特定设施的努力转向标准化的、全国一体化的CBRNe准备战略，优先考虑护理人员并赋予其权力。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Emergency Nursing NURSING-

CiteScore

3.20

自引率

11.10%

发文量

期刊介绍： International Emergency Nursing is a peer-reviewed journal devoted to nurses and other professionals involved in emergency care. It aims to promote excellence through dissemination of high quality research findings, specialist knowledge and discussion of professional issues that reflect the diversity of this field. With an international readership and authorship, it provides a platform for practitioners worldwide to communicate and enhance the evidence-base of emergency care. The journal publishes a broad range of papers, from personal reflection to primary research findings, created by first-time through to reputable authors from a number of disciplines. It brings together research from practice, education, theory, and operational management, relevant to all levels of staff working in emergency care settings worldwide.